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Clinical Experiences

Below is a partial listing of clinical experiences and practice settings available to APRN students. If you have questions about any of the experiences listed below, email APNstudenteducation@metrohealth.org.

Available Opportunities

Adult Medical/Surgical Rehabilitation and Adult ICU (CNS or CNP)

Preceptor: Shelly Amato, RN, MSN, CRRN, CBIS; Victoria Bowden, MSN, RN, ACNS-BC; Cheryl Bradas, MSN, RN, GCNS-BC, CHPN; Kathleen Kerber, MSN, RN, CCRN, ACNS-BC; Dawn Grimm, MSN, RN, CCRN, CCNS; Barbara Halliday, MSN, RN, ACNS-BC; Cristina Sanders, MSN, CNP; Mary Ann Woods, CNP, MSN

The student will actively participate with:

  • Collaboration with interdisciplinary team to solve patient focus problems
  • Empowerment of nursing staff by designing and implementation of programs to meet staff educational need
  • Identify practice issues and utilize evidence based practice as catalyst for change
  • Develop skills to lead performance improvement projects
  • Role modeling for nursing staff
  • Creating and advising nursing/system policy 

Cardiology (CNP or CNS)

Adult General Cardiology and Subspecialties

Preceptor: Sharon Mack, MSN,CNP ; Thutam Le, MSN, CNP

Adult General Cardiology and Subspecialties

The MetroHealth Heart & Vascular Center offers student experiences in general and subspecialty cardiology. The student may participate in the care of cardiac patients in the 24-hour clinical observation unit of the emergency department or in the outpatient clinic setting. The student has the opportunity to actively participate in the evaluation and management of hyperlipidemia, hypertension, anticoagulation, coronary artery disease, atrial and ventricular dysrhythmias, syncope, implantable device therapy, heart failure, and chronic disease management. In addition, the student is expected to attend meetings, lectures, and cardiology grand rounds as pertinent to his/her clinical experience.

Students with critical care or cardiology experience are preferred. Baseline skills required for this rotation include history and physicals, lab interpretation, familiarity with 12-lead ECG interpretation.

Chronic Kidney Disease (CNP)

Preceptor: Eileen Fisher, CNP, MSN

The student will participate in the management of Chronic Kidney Disease Stage II though End Stage Renal Disease. The student will also participate in the management of outpatient dialysis access issues. 

Diabetic Foot Clinic (CNP)

Preceptor: Denise Forster Paulsen, CNP, MSN, CRRN

The student will conduct visits in an outpatient clinic serving primarily diabetics with foot issues as a result of their disease. The majority of these patients have complex, chronic foot ulcers. The goals of the clinic are to manage/heal wounds and to promote foot health in diabetics through education and prevention strategies. This is an APRN-managed clinic with Vascular Surgery collaboration. The student will:

  • Conduct wound evaluations and manage wounds using up to date topical therapies
  • Focus attention on the vascular, nervous, and musculoskeletal systems as these relate to foot ulcer development and progression
  • Evaluate for psychosocial issues and availability of resources that impact wound healing
  • Provide Diabetic foot education
  • Evaluate current disease management as it relates to wound healing
  • Work closely with Infectious Disease to manage infections that frequently arise as a complication of the foot ulcers
  • Evaluate for appropriate footwear, working closely with an on-site prosthetist for evaluation and ongoing monitoring/modification of shoe wear to promote healing and prevent deformities, pain, and further ulcerations
  • Assist patients in procuring appropriate adaptive/DME equipment to facilitate offloading to promote healing and optimize safe mobility
  • Triage patients for need for referrals to vascular or orthopedic surgery and/or podiatry

Emergency Department (CNS)

Preceptor: Mary Sokolowski MSN, RN, ACNS-BC, CEN

The student will participate in and learn:

  • Education/in-service of nursing staff
  • QA projects/audits
  • Performance improvement projects
  • Clinical practice related to unit bases policy and procedure review
  • Non-acute/acute/trauma patient care monitoring

Emergency Department (CNP)

Preceptor: Susan Jamison FNP-C ; Jason Lu, CNP

The student will participate in and learn:

  • Level I Trauma Center with over 100,000 patient visits per year
  • Direct care and management of patients across the entire lifespan
  • Increased awareness of the special needs of the uninsured and under insured patient population
  • Member of multidisciplinary health care team to address total patient care--Mental Physical and social
  • Suturing, fracture care, abscess care and management, motor vehicle collisions, animal bites, and domestic violence
  • Routine ED patients such as musculoskeletal pain and injuries, viral illnesses, STDs, early OB intervention, sick child care, headaches, odontalgia, and rashes
  • Increase proficiency of abdominal pain exam across the lifespan and early detection of pathology to prevent later complications

Geriatric Medicine (CNP)

Preceptor: Mary Jo Slattery, MSN, CNP

The student will participate in the assessment of geriatric patients for primary care and chronic illness care.  Focused illness visits are part of the practice.  The student will also learn about office/practice management.


Infectious Disease (CNP)

Preceptor: Deirdre Raimey, MSN, CNP; Kathryn Meyer, DNP, CNM, FPNP

The Infectious Disease Clinic focuses on Sexually Transmitted Infections.


Lead Poisoning Clinic (CNP)

Preceptor: Roberta Anderson, CNP

The student will have experiences in well child care as well as be part of the comprehensive clinic for children (six years of age or younger) with lead poisoning and their siblings. The student will participate with interventions to decrease lead exposure through environment and nutrition. The student will be a housing advocate and work with the Cleveland and Cuyahoga County Departments of Health along with Cleveland Metro Housing Authority.

The student will advise on litigation issues relating to lead poisoning. The student will also work in the outpatient clinics and follow up for lead poisoning and make appropriate referrals for problems associated with lead toxicity such as speech delay, behavioral problems, and anemia.

Long-Term Care Services/Rehabilitation Services

Preceptor: Barbara Haubrich, CNP, MSN Tiffany Leake, RN, MSN, CNP ; Donna Westfall, CNP, MSN; Kathryn Zabak, CNP, MSN ; 

The student will gain experience in:

  • Acute care visits
  • Routine care visits
  • Admissions
  • Wound care rounds

The student may be assigned to a variety of settings including MetroHealth's Skilled Nursing units, assisted care living facilities or community sites including a continuing care retirement community that provides comprehensive care across the continuum including office visits, assisted living, and skilled and long term care.

McCafferty Health Center Pediatrics (CNP)

Preceptor: Veronica Crowe Carpenter , CNP

The student will participate in the following:

- Well child care physicals (birth to 18 years)
- Illness visits (birth to 18 years)
- Pre-school physicals
- Sports physicals
- Multicultural families; inner-city populations, including patients with Spanish, Arabic, Vietnamese/Cambodian, African American, and Eastern European immigrant backgrounds

Neonatal Intensive Care Unit (CNP and/or CNS)

Preceptor: Sheila Gesing, CNP; Julie Medas, CNS; Julie Zupancic, CNP; Marie McDonell, CNP.

The student will participate in the care and management of critically ill neonates and premature infants in the 49-bed NICU, including:

The CNP role includes:

  • high risk delivery stabilization
  • NICU admission examination and procedures
  • ongoing medical management of patients
  • communication and education of parent/family
  • extensive discharge planning

The CNS role includes:

  • facilitation of learning through program development for staff
  • collaborate with staff/multidisciplinary team on performance improvement initiatives
  • mentoring professional development of staff and CARE program roles
  • change agent to ensure evidence-based practice integration into clinical practice
  • participation in research
  • consult on complex patients
  • ensure compliance with regulatory agency standards/TJC patient safety goals

Neurosurgery

Preceptor: Lori Mertz, MSN, CNP

Newborn Nursery (CNP)

Preceptors: Sandra Wright-Esber, CNP, IBCLC, MA; Sue Griffith, CNP, Meggan Dwyer, CNP, Gloria Gordon-Ocejo, CNP

Students will participate in the:

  • Admission of newborns
  • Parental education
  • Newborn physical exams (normal and high-risk infants)
  • Daily assessment of newborns
  • Discharge exams and extensive discharge planning

 Nurse Practitioners in the nursery deal with a number of types of infants:

  • heroin/methadone exposure
  • teen mothers
  • cocaine exposure
  • social high risk
  • stabilization of infants including septic work-ups, antibiotic administration, IV placements, blood draws
  • management of premature infants at near term greater than 36 weeks

Pediatrics:  General Pediatrics with a Concentration in Adolescent Medicine (CNP)

Preceptor: Melissa Lohr-Panzero, CNP

Students who are experienced RNs and have completed at least one clinical semester can apply for this experience. Available hours are Wednesdays and Thursdays, 5-8 p.m. and occasional Saturdays, 8 a.m.-12 p.m. The main focus of each clinic is the primary care of adolescents (including gynecologic care).

Pediatrics: General Pediatrics and Pediatric Endocrinology (CNP)

Preceptor: Barbara Lightner, CNP; Melissa Lohr-Panzero, CNP

Well child care will take place one day per week. Pediatric endocrinology will include management of endocrine disorders in children two days per week. Experience includes conducting history and physical exams, creating assessment plans, and educating pediatric endocrine patients and their families.

Pediatrics: Gastroenterology (CNP)

Preceptor: Christine Garapic, CNP

Experiences will include obtaining history, performing physical examination, patient/family education in the evaluation and management of children with digestive system disturbances two days per week or rheumatologic disorders one day per week.

Pain Management (CNP)

Preceptor: Eileen Coppola, CNP; Todd Markowski, CNP 

The student will participate in the assessment and treatment of patients with chronic pain.

Primary Care (CNP)

Preceptor: Jean Nagy, FNP-BC; Maureen Ioannu, MSN, CNP; Alishea Gay, CNP                                               
The student will participate in the assessment of patients of all ages for primary care and chronic illness care.  Focused illness visits are part of the practice.The experiences are held on main campus as well as satellite clinics. 

Primary Care (CNP)

Susann Telmanik, Certified Family Nurse Practitioner in Primary Care

The student will gain experience in all aspects of primary care from newborns to seniors in a Community Health Clinic (Buckeye). Patient health care needs vary from well care/preventive to management of acute and chronic illnesses.

Primary Care (CNP)

Preceptor: Alishea Gay, CNP

Experience includes primary care and management of acute and chronic conditions.

Pulmonary and Sleep Medicine (CNP)

Preceptor: Karen Majewski, CNP; Valerie Ross, CNP;  Jan Steinel, CNP   

The student will participate in the diagnosis and management of chronic pulmonary disorders such as COPD and asthma. The student will also participate in the diagnosis and management of common sleep disorders such as OSAHA, insomnia, restless leg syndrome, and sleep hygiene disorders. Additional experience is available by participating in the in-hospital treatment of OSAHS.

The Psychiatric Advanced Practice Nurse (CNS or CNP)

MetroHealth's Department of Psychiatry comprises mental health professionals from various disciplines. Together, they provide outpatient, inpatient and consultation/liaison services for patients from the Greater Cleveland area. The department is committed to delivering competent and compassionate mental health care.

The Psychiatric Advanced Practice Registered Nurse (PAPRN) for Outpatient Psychiatry

Preceptors: Margaret Blasse, RN, PMHCNS-BC; Tina Oney, RN, PMHCNS-BC; and Rebecca Snider-Fuller, RN, PMHCNS-BC

Provides assessment, diagnosis, and treatment to individuals or families with psychiatric problems/disorders or the potential for such disorders. The PAPRN in Outpatient psychiatry provides a full range of primary mental health care services, functions as a psychotherapist, educator, advanced case manager, consultant to primary care physicians, and collaborator to achieve an optimum level of community support. The PAPRN prescribes and manages psychopharmacologic treatments.

The student will actively participate in:

  • Performing mental health assessments and diagnosis of patients with mental illness in the outpatient setting
  • Examining laboratory values pertinent to patient’s illness and treatment plan
  • Decision making about pharmacotherapy and other treatment modalities

The Psychiatric Advanced Practice Registered Nurse (PAPRN) for the Department of Nursing

Preceptor: Rosanne Radziewicz, RN, PMHCNS-BC

Provides clinical support to the nursing team through consultation and education. The PAPRN meets with nurses to enhance their clinical practice skills through education, research, patient consultation, and by promoting leadership to enhance an optimal treatment environment. In addition, the PAPRN for Nursing is a consultant and direct care provider for patients with psychiatric needs in other subspecialties throughout the MetroHealth System including Infectious Disease and Cancer Care. The PAPRN provides support to the Consultation Liaison Psychiatric Team, coordinates restraint reduction efforts, and promotes/coordinates integrative therapies.

The student can participate in:

  • Rounding on general medical nursing units for consultation about behavioral concerns and plan treatment with nursing groups
  • Identifying practice and system issues and collaborate on strategies toward goals
  • Educating in the liaison role the nursing and other health care staff on psychiatric, psychosocial and team relationships as needed
  • Performing mental health assessments and diagnosis of patients with mental illness in the inpatient and/or outpatient setting
  • Examining laboratory values pertinent to patient’s illness and treatment plan
  • Decision making about pharmacotherapy and other treatment modalities

Red Carpet Care Program

Preceptors: Carol Sams, MSN, ANP-BC, Family Medicine Clinic, MHMC; Pamela Crider, MSN, ANP-BC, MetroHealth Broadway Health Center 
  
Students
: Adult/Gero NP, Family NP tracks 

Nurse Practitioner Case Managers work with adult "super-utilizer" patients, their PCP, specialists and payers to manage chronic disease(s) and prevent ED visits and hospitalization. 

Clinical experience: Maximum of 40 hours over 4-5 weeks to achieve continuity of care. 

Types of Experiences:
-Chronic Disease Management for Diabetes, HTN and heart failure.
-Care coordination
-Collaboration with ED and inpatient staff
-Acute and episodic home visits
-Acute clinic visits
-Comprehensive histories, physical exams, management and treatment of chronic illnesses.
-Health Maintenance

Internal - MetroHealth System
External - other institutions, home care, community partner
Decision making about pharmacotherapy and other treatment modalities

Women's Health Care & OB/GYN Clinic (CNP)

Preceptors (from left to right below): Debbie Bazzo, WHNP-BC; Elizabeth Cottom, WHNP-BC; Laura Doi, WHNP-BC; and Catherine Rhodes, WHNP-BC. Not pictured: Sylvia Saikus, CNM     

Student will gain experience in:

  • Well women care from adolescent age through menopause
  • Antepartum and postpartum care
  • Adolescent pregnancy care clinic
  • Diagnosis management, treatment of common gynecological conditions (STD's, vaginitis, UTI's, PMS)
  • Contraceptive management
  • Colposcopy services
  • Menopausal management
  • Counseling and education for patients on healthy relationships, sexuality, healthy lifestyles, parenting, domestic violence, and referrals to appropriate services
  • Specialty experiences available include colposcopy and urogynecology

Wound Care Clinic (CNP)

Preceptor: Denise Forster Paulsen, CNP, MSN, CRRN

The student will conduct visits in an outpatient clinic serving primarily catastrophically injured patients such as spinal cord injured patients with pressure ulcers. In addition to evaluation and management of their wounds, the focus is on nutrition, care coordination in the community, procuring appropriate adaptive equipment to promote healing, and attention to psychosocial issues as they relate to wound healing. This is an APRN-managed clinic with Trauma Surgery oversight.

800-554-5251



SAVE THE DATE:

Advanced Practice Registered Nurse
Pharmacology Conference 2014

Friday, October 10, 2014 
in MetroHealth Medical Center's
Scott Auditorium

REGISTER ONLINE

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© Copyright 2002 - The MetroHealth System|2500 MetroHealth Drive|Cleveland, OH 44109|(216) 778-7800|All Rights Reserved.
  • © Copyright 2002 - The MetroHealth System
  • 2500 MetroHealth Drive|Cleveland, OH 44109|(216) 778-7800
  • All Rights Reserved.